Timothy Noah at Slate Explains Why Public Option *Is* the Straw that Stirs the Drink

Here's the link. Here's the essence of his argument:

Why is the public option so vitally important to health reform?

At the broadest possible level, the public option is necessary simply because it's impossible to identify a successful health system anywhere in the world based on a for-profit insurance model. If profit-driven health insurance could be made to work, then surely somebody would have figured it out by now. Paul Krugman, in an Aug. 17 New York Times column, likens health reform to the reforms Switzerland instituted in 1994: "[E]veryone is required to buy insurance, insurers can't discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies." But there's a significant difference. In Switzerland, private insurers are required to provide basic health coverage on a nonprofit basis. Under Obamacare, private insurers will continue to seek profits, and it's quite possible that the new regulatory restraints imposed on them (take all comers, don't punish the sick with higher premiums, don't seek out fine-print reasons to cancel policies after policyholders get sick, etc.) will inspire them to find ever-more-ingenious ways to avoid payouts. President Obama often says that a public option will help keep the private insurers honest. What he doesn't say, but surely knows, is that private insurers' duties to their shareholders may be irreconcilable with their duties to their customers.

Kevin Drum, the Old 'CalPundit' on How the Public Option is Not the Sine Qua Non

His complete argument. He makes sense, I think -- that's what I want to think since the public option seems to be in trouble. But to be honest, on this issue I tend to agree with whomever I read last. I guess I'll put up Howard Dean's take on it al tomorrow....

As much as I'd like to have a public option (primarily for its ability to force more robust price competition), I just don't see it as something to threaten nuclear destruction over. If insurance reforms are robust and low-income subsidies are decent, that's a huge win for millions of people, and it's a win we can build on. And contra Atrios, social legislation does have a history of getting better after it's first passed. Just ask Henry Waxman.

There's more to say about this. For example: most European countries rely on regulated private insurers of one kind or another to provide universal coverage, and they've managed to make this work. And: a credible threat only works if the opposition is afraid you might carry it out. But as near as I can tell, the folks who oppose the public option aren't really all that afraid of the possibility that healthcare reform sinks completely. Plus: the only way to get it is via reconciliation, and various comments to this post make it pretty clear that trying to pass a huge healthcare bill via reconciliation is probably impossible.

It's worth fighting for a public option. But it's not worth sinking healthcare reform over it. That would hurt too many real flesh-and-blood people who need this, and a second chance wouldn't come along for a long time. We've failed on the healthcare front too many times to accept failure again.